True Impact of the Indication of Cirrhosis and the MELD on the Results of Liver Transplantation

Santoyo-Santoyo, Julio; Suárez, Miguel Ángel; Fernández-Aguilar, José Luis; Daga, J.A. Pérez; Sánchez-Pérez, Belinda; Ramirez, Carlo B.; Aranda, José Manuel Ramírez; Rodríguez‐Cañete, Alberto; González-Sánchez, Antonio Jesús

doi:10.1016/j.transproceed.2006.08.015

Cited by 14 publications

(18 citation statements)

References 8 publications

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“…The impact of MELD score on postoperative mortality remains elusive. There are reports of reduced survival in groups with high MELD scores [5,6], but also reports of no influence of MELD score on survival [7,8]. …”

Section: Introductionmentioning

confidence: 99%

Model of end stage liver disease (MELD) score greater than 23 predicts length of stay in the ICU but not mortality in liver transplant recipients

et al. 2010

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IntroductionThe impact of model of end stage liver disease (MELD) score on postoperative morbidity and mortality is still elusive, especially for high MELD. There are reports of poorer patient outcome in transplant candidates with high MELD score, others though report no influence of MELD score on outcome and survival.MethodsWe retrospectively analyzed data of 144 consecutive liver transplant recipients over a 72-month period in our transplant unit, from January 2003 until December 2008 and performed uni- and multivariate analysis for morbidity and mortality, in particular to define the influence of MELD to these parameters.ResultsThis study identified MELD score greater than 23 as an independent risk factor of morbidity represented by intensive care unit (ICU) stay longer than 10 days (odds ratio 7.0) but in contrast had no negative impact on mortality. Furthermore, we identified transfusion of more than 7 units of red blood cells as independent risk factor for mortality (hazard ratio 7.6) and for prolonged ICU stay (odds ratio [OR] 7.8) together with transfusion of more than 10 units of fresh frozen plasma (OR 11.6). Postoperative renal failure is a strong predictor of morbidity (OR 7.9) and postoperative renal replacement therapy was highly associated with increased mortality (hazard ratio 6.8), as was hepato renal syndrome prior to transplantation (hazard ratio 13.2).ConclusionsThis study identified MELD score greater than 23 as an independent risk factor of morbidity represented by ICU stay longer than 10 days but in contrast had no negative impact on mortality. This finding supports the transplantation of patients with high MELD score but only with knowledge of increased morbidity.

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Section: Introductionmentioning

confidence: 99%

Model of end stage liver disease (MELD) score greater than 23 predicts length of stay in the ICU but not mortality in liver transplant recipients

et al. 2010

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“…The part of liver tissue obtained by needle biopsy, in many instances, particularly in cases of CLD fails to provide a correct assessment of changes in the whole liver [15,18]. Some of the recent reports on the epidemiology of different types of end-stage CLD in the general population and their future projections have been based, to a significant extent, on data from LT centers [2][3][4]. A review of the etiologic assessment of CLD (even though not done in as extensive a manner as in our LT cases) in a much larger number of cases seen in our hospital liver clinics over the same period of time showed frequencies of the different categories to be very similar to those in the study reported here.…”

Section: Discussionmentioning

confidence: 99%

“…Success in liver transplantation (LT) achieved during the last two decades has provided substantial relief to such cases of end-stage CLD [1][2]. Besides, analyses of data from different LT centers in developed countries have yielded a considerable important information such as epidemiology and temporal changes in end-stage CLD [1,[2][3][4], detection of precancerous lesions and small cancers in the liver [6,7] as well as selection, prioritization, and management of cases in an LT program [1,2,6].…”

Section: Introductionmentioning

confidence: 99%

Etiologic types of end-stage chronic liver disease in adults

Nayak¹,

Jain²,

Vasdev³

et al. 2012

European Journal of Gastroenterology & Hepatology

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The etiology of end-stage CLD in adults of our region has changed over time. HCV, more than HBV, is now the major cause of both CLD and HCC; alcohol-related CLD has increased significantly and several cases of cirrhosis clinically considered as cryptogenic, some of them with HCC, evolve from NAFLD. A proportion of cryptogenic cirrhosis cases that require LT are constituted by the noncirrhotic disease noncirrhotic portal fibrosis.

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“…There was no signifi cant difference of the length of OT between patients in different MELD score groups (P > 0.05) experts. [3][4][5][6]15 A perfect model for organ allocation should not only allocate organs to sicker patients but also identify the patients who would benefi t most from transplants. 16 In this respect, MELD is imperfect.…”

Section: Discussionmentioning

confidence: 99%

Model for end-stage liver disease versus the Child-Pugh score in predicting the post-transplant 3-month and 1-year mortality in a cohort of Chinese recipients

Guo

et al. 2009

Surg Today

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True Impact of the Indication of Cirrhosis and the MELD on the Results of Liver Transplantation

Cited by 14 publications

References 8 publications

Model of end stage liver disease (MELD) score greater than 23 predicts length of stay in the ICU but not mortality in liver transplant recipients

Model of end stage liver disease (MELD) score greater than 23 predicts length of stay in the ICU but not mortality in liver transplant recipients

Etiologic types of end-stage chronic liver disease in adults

Model for end-stage liver disease versus the Child-Pugh score in predicting the post-transplant 3-month and 1-year mortality in a cohort of Chinese recipients

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